Chemoradiation-induced Oral Mucositis
Oral mucositis is probably the most common, debilitating complication of cancer treatments, particularly chemo and radiation therapies in head and neck cancer. It can lead to several problems, including pain, nutritional problems as a result of inability to eat, and increased risk of infection due to open sores in the mucosa. The symptoms have a significant effect on the patient’s quality of life and can limit the doses and duration of cancer treatment, leading to sub-optimal treatment.
Who Gets Oral Mucositis?
Most oral cancer, leukemia, and head and neck cancer patients receiving chemoradiation therapy experience severe oral mucositis. Chemotherapy leads to neutropenia in blood vessels and neutrophil infiltration in mucosal tissues. Radiation therapy causes damage to DNA and many damage-associated molecular patterns (DAMPs), leading to severe oral mucositis.
The estimated incidence of head and neck cancer across the world accounts for approximately 886,939 per year, and the number is consistently increasing. In the U.S. alone, it is estimated that about 65,630 will develop head and neck cancer in 2020. Chemoradiation-induced oral mucositis occurs in up to 80% of head and neck cancer irradiated patients. Grade 3 and 4 (severe) oral mucositis (SOM) has been recorded in 56% of head and neck cancer patients who were treated with radiotherapy. Today’s publicly available Phase 2 clinical studies results show incidence of SOM ranged from 60 to 69, with the average SOM of 65%.